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Organization
ADVANCED THERAPEUTIC SERVICES INC
Active
Organization
ADVANCED THERAPEUTIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY FRANK KOLACZKOWSKI MSW LISW LCSW (EXECUTIVE DIRECTOR)
(937) 223-1781
Entity
Organization
Contact information
Practice address
1320 WOODMAN DR, STE 200, DAYTON, OH 45432
(937) 223-1781
(937) 853-0096
Mailing address
1320 WOODMAN DR, STE 200, DAYTON, OH 45432
(937) 223-1781
(937) 853-0096
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2299196
—
OH
Enumeration date
11/09/2005
Last updated
03/24/2008
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